Neural Fibrolipoma : Imaging

Neural Fibrolipoma - Imaging: This MRI (Axial T1) is from a 50 y/o male who presented with a swollen forearm and hand (same case as the previous image). There is an extensive neural fibrolipoma of the median nerve. The nerve is grossly thickened with lipomatous tissue interdigitating between prominent fascicles creating a 'coaxial cable'-like appearance. This abnormality extended from the level of the elbow joint all the way into the digital nerves of all the fingers. The nerve has a maximal diameter in the carpal tunnel with gross bowing and convexity of the overlying carpal tunnel retinacula sheath. There is associated macrodactyly of the index finger and thumb and cutaneous thickening (see previous image).

Case courtesy of Andrew Lawson, Radiopaedia.org. From the case rID: 28312